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A large group of patients have an unhealthy and disabling wish to be special. The original trauma to which they have been subjected can be described as a failure of the mother to respond appropriately to the patient's need for individuality. The result is a need to establish a special relationship with the mother in which the child feels valuable only because of this relationship; it is then carried over into all his other object relationships.
Following a case presentation, Lomas attempts to separate from a vicious circle of interacting factors those elements he feels are responsible for this need to be special. A few of them are: a strong tendency to narcissism, a rigid family structure, and a preoccupation on the part of the mother with the patient's existence and functioning rather than simple acceptance of him.
If, as a result of these factors, the child develops a pathological craving for recognition, the results are personally destructive unless, through unusual talent or fortuitous circumstances, he is able to achieve a special place. In such cases the disturbance may pass unnoticed.